急诊科容量状态及液体反应性评估
Assessing volume status and fluid responsiveness in the emergency department.
作者信息
Mackenzie David C, Noble Vicki E
机构信息
Department of Emergency Medicine, Maine Medical Center, Portland, ME, USA.
Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
出版信息
Clin Exp Emerg Med. 2014 Dec 31;1(2):67-77. doi: 10.15441/ceem.14.040. eCollection 2014 Dec.
Abstract
Resuscitation with intravenous fluid can restore intravascular volume and improve stroke volume. However, in unstable patients, approximately 50% of fluid boluses fail to improve cardiac output as intended. Increasing evidence suggests that excess fluid may worsen patient outcomes. Clinical examination and vital signs are unreliable predictors of the response to a fluid challenge. We review the importance of fluid management in the critically ill, methods of evaluating volume status, and tools to predict fluid responsiveness.
摘要
静脉输液复苏可恢复血管内容量并改善心输出量。然而，在不稳定患者中，约50%的液体冲击未能按预期改善心输出量。越来越多的证据表明，过多的液体可能会使患者的预后恶化。临床检查和生命体征并不是预测液体冲击反应的可靠指标。我们综述了危重症患者液体管理的重要性、评估容量状态的方法以及预测液体反应性的工具。
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本文引用的文献
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Ann Intensive Care. 2014 Jun 21;4:21. doi: 10.1186/s13613-014-0021-0. eCollection 2014.
2
Correlation of corrected flow time in the carotid artery with changes in intravascular volume status.
J Crit Care. 2014 Aug;29(4):486-8. doi: 10.1016/j.jcrc.2014.03.025. Epub 2014 Apr 2.
3
Early fluid loading in acute respiratory distress syndrome with septic shock deteriorates lung aeration without impairing arterial oxygenation: a lung ultrasound observational study.
Crit Care. 2014 May 6;18(3):R91. doi: 10.1186/cc13859.
4
A 10-second fluid challenge guided by transthoracic echocardiography can predict fluid responsiveness.
Crit Care. 2014 May 27;18(3):R108. doi: 10.1186/cc13891.
5
Limited echocardiography-guided therapy in subacute shock is associated with change in management and improved outcomes.
J Crit Care. 2014 Oct;29(5):700-5. doi: 10.1016/j.jcrc.2014.04.008. Epub 2014 Apr 26.
6
Damage Control Resuscitation In Trauma.
Scand J Surg. 2014 Jun;103(2):81-88. doi: 10.1177/1457496914524388. Epub 2014 Apr 28.
7
A randomized trial of protocol-based care for early septic shock.
N Engl J Med. 2014 May 1;370(18):1683-93. doi: 10.1056/NEJMoa1401602. Epub 2014 Mar 18.
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Evaluation of pulse pressure variation validity criteria in critically ill patients: a prospective observational multicentre point-prevalence study.
Br J Anaesth. 2014 Apr;112(4):681-5. doi: 10.1093/bja/aet442. Epub 2013 Dec 29.
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FALLS-protocol: lung ultrasound in hemodynamic assessment of shock.
Heart Lung Vessel. 2013;5(3):142-7.
10
Liberal versus restricted fluid resuscitation strategies in trauma patients: a systematic review and meta-analysis of randomized controlled trials and observational studies*.
Crit Care Med. 2014 Apr;42(4):954-61. doi: 10.1097/CCM.0000000000000050.
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